Although it was initially planned that I would return to Kandahar Airfield at this time, I was asked yesterday to cover another base (FOB Leopard, northeast of FOB Lynx) for the next month, to give the senior medic there a break (he had been at the base since August).

The distance between the two bases is less than 10 kilometres, so helicopter transport was not going to happen.

That meant I would have to join a convoy and go by road. This is a lot worse than going cross-country on an attack since improvised explosive devices are almost never placed out in open fields - they are almost always placed where there is a high probability of a vehicle passing over them.

The most dangerous thing you can do here is to go down a road. And the road we would have to take was recently acknowledged to be the second-most dangerous road in the world (a road in Iraq took first place).

It gets worse. Since it had been some time since anyone had driven on this road, the likelihood of IEDs was considered extremely high. The convoy making the trip was therefore a mine-clearing operation.

This is an operation run by the engineers to detect and destroy any IEDs that have been placed along our access roads. There were also a couple of light armoured vehicles with infantry troops for security, an armoured bulldozer and a couple of pickup trucks with Afghan National Army soldiers for added security and to interact with the locals.

The commander rides more or less in the middle of the convoy and that's where I was loaded.

While it was certainly comforting to have all of that mine-detection equipment and expertise out in front of me, this was negated by the fact that we had to clear the road all the way to the outpost west of us before heading east to FOB Leopard, effectively tripling the distance and the time we would be exposed to attack.

This is likely to be the longest road trip I will undertake through an area of high Taliban activity. The troops do this regularly and are either used to it or very brave or, most likely, both. For myself, I slept poorly till about 4 a.m. and not at all after that. I don't think anyone could tell how I was feeling - I still have a lot of pride, maybe too much - but I got fairly quiet.

I spent my last evening at FOB Lynx packing and going over every last piece of my gear, particularly my weapons, to make sure everything was as "tight" as possible. I sterilized my camel bag (a four-litre water container that goes on your back) and filled it to the brim. I double-checked every pouch on my tac vest, making sure that all my ammunition and medical gear was snug, yet easily accessible. And I don't think my rifle and pistol have ever been cleaner.

The seriously wounded soldiers I have treated were all injured by IED strikes on vehicles. While waiting to board my LAV, I kept seeing their severe leg wounds, some of which had led to amputations. My awareness of my lower limbs, which had gone back to normal a couple of days after the last IED strike, became exquisite again.

We left FOB Lynx right after breakfast. As the vehicles crossed the gate, everybody was locked and loaded - weapons fully loaded, a round in the breech, a flick of the safety and we are ready to fire.

I took my position in one of the rear hatches of the LAV. The routine here is to scan your "arc" more or less continuously, using the scope on your rifle to closely examine anything that looks suspicious. As I was the aft starboard sentry, my arc was 3 o'clock to 6 o'clock (12 o'clock being the front of the vehicle).

For most of the trip we were in flat, open terrain. Potential ambush sites were at least 200 metres away. The fire would be less accurate and we would have a few seconds to react. At other times there was good cover all the way up to the road.

The road to the outpost took us by a Taliban cemetery. Everyone lying there had been put in the ground by us. I was happy they were dead, but you can't help but reflect on the wastefulness of war in places like this.

We spent an hour at the outpost, resupplying the troops there. We then went back the way we came, past the turn-off to FOB Lynx and on to the east. As we got close to the village beside FOB Leopard, the scene became a cliché: heavily armed Western troops in armoured vehicles riding through an area crawling with kids, all of them dirt-poor and begging for hand-outs.

We didn't stop to interact with the children, nor did we give them anything. Anyone who has been to the developing world knows that giving kids hand-outs encourages the worst kind of dependency. Here in Afghanistan, there is an even better reason.

On Sept. 18, 2006, a soldier from Espanola, Pte. David Byers, was killed not far from here. He died, along with three other Canadians, when a Taliban suicide bomber on a bicycle drove into them while they were feeding Afghan children. There were 27 Afghan casualties that day, most of them children.

Dec. 21: FOB Leopard - the downside

There is only one downside to serving at FOB Leopard, and it is summed up nicely in a sign that hangs beside one of the other bunkers: This place has the dubious distinction of having had the most rocket hits of any FOB or outpost in Afghanistan. After IEDs, these 107 mm and 122 mm weapons are the things we fear most, as they have the largest warhead of anything in the Taliban arsenal.

They make a hissing noise as they go by. This is good to hear as it means the rocket is already moving past you.

As they had done at KAF, the Taliban celebrated my arrival yesterday, this time with a mortar round. Fortunately, though unnervingly, these bombs travel slower than the speed of sound. Their arrival is announced by a high-pitched whistling that you learn to recognize very quickly and which I recalled from my infantry days. This gave me a few seconds to hit the dirt before the mortar impacted. Unlike that first rocket at Kandahar Airfield, I can tell you exactly where this one hit. No one here is blasé about these weapons.

I was wondering why FOB Leopard was the subject of so much high-explosive attention. It was explained to me that various Taliban specialize in different weapon systems. The ones around this FOB are "rocket men." Great.

As a result, almost every installation of any consequence here at FOB Leopard is surrounded by concrete barriers, the same ones that make up the rocket shelters at Kandahar Airfield.

Dec. 22 - The Enemy Within

Quite a dramatic title, eh? Were you thinking that I was going to talk about Taliban infiltration of the Afghan National Army and Afghan National Police? Hoping for tales of cloak-and-dagger, watching men for tell-tale signs of treachery, capturing spies and then "making them talk"?

Sorry to disappoint you.

The enemy I refer to is the cause of more medical downtime in this war than any other single cause: infectious diseases.

It must be said that things have improved quite a bit in the last 100 years. In my sailing trips around the Caribbean, I have delved into the medical aspects of the various armies that sought to establish empires in the region. The situation for troops coming to the tropics from Europe was dismal. It was not unusual for troops stationed on these idyllic islands to experience mortality rates of 50 per cent. This was when there was no war going on. Dysentery, typhus, yellow fever and, above all, malaria, decimated the ranks.

A little historical aside. Even people in the medical field in Canada have difficulty appreciating the impact of malaria on human health. It infects 300 million people a year and kills approximately 3 million. In his book "The Fourth Horseman," Andrew Nikiforuk makes a convincing case that, until fairly recently, malaria had killed one-half of all the human beings who had ever died. Ever.

Things are far better for the Canadian Forces of 2007 than for virtually any army that has gone into the field before us. Nonetheless, our troops in the field are in an environment where the transmission of various pathogens is facilitated. We live fairly closely together. We are often dirty, tired and under stress. Cleanliness is difficult to maintain.

So it was not entirely surprising that I arrived here to find the camp on the verge of an outbreak of gastroenteritis. There had been seven cases in three days and six more were diagnosed in my first two days here.

There were two obvious problems. A quick tour of the latrines showed that two-thirds of them did not have hand sanitizer. I had noticed a lot of people coming out of the latrines without washing their hands. Not their fault if the army did not give them the wherewithal to do so. Easy fix: I went to the supply shacks, got a couple of cases of sanitizer and put one in each latrine.

The next problem was trickier. There was a hand washing station near the mess tent (the place the troops eat) but it was far from the entrance, so less than a quarter of the soldiers were using them. The soap dispensers were broken. Worst of all, there were no paper towels. The troops who did wash their hands would dry them on their combat uniforms, effectively negating the good they had done.

This took a bit more effort. Much to the amusement of the rest of the medical staff, I got a shovel and rake and flattened out a platform right beside the entrance to the food-serving line. I then dragged the hand-washing stations over. I drilled small holes in the tops of empty water bottles and put some hand soap in them. Then I located a massive supply of paper towels (which had apparently been there for months) and had some crude dispensers made for them.

Now it was time to change some long-standing behaviour patterns. I spent 48 hours guarding the mess hall. No one got by me without washing their hands. As you can imagine, I took a fair amount of guff from the troops, but after two days I could stand back and watch the effects: Troops lining up to wash hands.

Postscript, Dec. 29: We are now five days gastro-free! This may be my single greatest contribution to the war effort.

Dec. 30: IED

It was around 9 a.m. when we heard the blast. The medic and I were standing outside the bunker. We looked northeast and saw the mushroom cloud of smoke and dust a couple of kilometres from the base perimeter.

There had clearly been a fairly large detonation, but there was no cause for concern yet. A number of benign explanations were voiced: engineers blowing something up, a rocket landing well short of its objective.

We could see that it had been very close to the road. No one wanted to say IED, though everyone was thinking about that possibility.

Two minutes later we had our answer. IED. No big deal, only one casualty, category Charlie. This means "May need surgery within four hours." So everyone piled into the ambulance and headed off, but not in a rush.

The reality proved to be far worse. As is often the case, the first report had been incomplete. There were five casualties, one of them severely wounded and unconscious. Nothing could be done for him. Cpl. Jonathan Dion was Canada's seventh fatality for this rotation.

This is getting harder to take, but not for the reasons you might expect. This is not my first time around this particular block. I have been in war zones before and my profession has made me intimately familiar with death. I almost certainly won't be coming back from this with Post Traumatic Stress Disorder or anything more than minor flashbacks that will resolve quickly. I've been here before and I am not unduly affected by what I have seen and done.

What is starting to bother me is something that is very difficult to avoid in a war zone: superstition. Since I have been in Afghanistan, I have been on-site for all the deaths and disabling injuries the Canadian Forces has suffered. The first episodes were at Kandahar Airfield, where I was just one MD on the team. The last two have happened to men on my base shortly after my arrival. There are several bases, so you see where I am going with this. It was statistically very unlikely that I would end up in the same place as all the casualties.

I care deeply about these men and these coincidences are getting to me. I am beginning to feel like an albatross.

Postscript, Jan. 1: The Medic was the first to get to the dying soldier and he did a superb job. Nonetheless, he was quite affected. He had dealt with dead Canadians before, but never dying ones.

He found this quite difficult and we talked about it at length. Like any dedicated health professional, he questioned whether he could have done anything else that might have saved our comrade's life.

We went over the case in detail and I assured him his performance had been flawless.